Sheffield Children’s Hospital one of first to introduce Martha’s Rule over sepsis case concerns

The family of Martha Mills, a 13-year-old who died from septic shock in a London hospital in 2021, campaigned successfully to allow patients and their families 24-hour access to a rapid review from a separate care team if they are worried about a person’s condition.

An inquest into Martha’s death last year found that her family’s concerns were not responded to after her condition deteriorated and she might have survived if she had been moved into intensive care earlier.

Sepsis, which is life-threatening, turns the body’s infection-fighting processes against it – if it turns into septic shock, a patient’s organs will start to fail.

Yvonne Millard, chief nurse at the hospital, spoke at a meeting of Sheffield City Council’s health scrutiny sub-committee yesterday during a discussion about the hospital NHS trust’s annual quality report. Sheffield Children’s runs 19 services for children and young people, not just the hospital, she said.

She said the hospital trust chose sepsis as its key priority for this year because its audits and investigations have shown that there is more to do on recognition and awareness of warning signs. “We know that patients aren’t always being treated quickly,” she said.

Awareness

The hospital has appointed a sepsis nurse, whose sole role is bringing awareness to other staff. Guidelines, training and early warning systems used when a child first becomes unwell have now all been improved, Ms Millard said.

The NHS trust is also working with families directly affected by sepsis and working with them.

Ms Millard said there is now an escalation service in place for parents and carers, giving them a route to get a second opinion. “We are one of the early adopters of Martha’s Rule,” said Ms Millard.

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More generally, Ms Millard also told councillors that a patient safety incident response framework has been changed to draw out much more learning from what has happened, which is the point of investigations.

“The key point is a compassionate approach,” she said. “It was never about blaming, it was about learning.”

She said that young patients and their families are at the centre of the process and all the learning about an incident is relayed to the family of a patient whose case has been investigated.

Bereavement

Another priority is the trust’s bereavement care, which Ms Millard said “is not as good as it should be. We have only got one chance to get that right for families and we need to do the best in that work.”

New bereavement coordinators take a whole family approach, involving not just parents but everyone who was important to that child or young person. Counselling services are offered via Bluebell Wood Children’s Hospice.

Craig Radford, the NHS trust’s chief operating officer, added that the NHS trust is also working on improving patient waiting times and supporting patients and families while they wait for treatment. There is a particular focus on neurodiversity waiting times, he said.

Committee chair Coun Ruth Milsom asked about the “low uptake” of flu vaccines by staff, which was 61 per cent. Ms Millard replied that is one of the highest-performing figures in the region.

She said efforts to overcome “vaccine hesitancy” included offering vaccinations from 7am to 10pm and incentive schemes.